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Launch Press Release: April 2004

Press Release: April 2003

Article: Maintaining a healthy planet - Nov/Dec 2003


Launch Press Release: April 2004

MATERIAL HEALTH: An assessment of the environmental sustainability of the NHS in England and Wales

A major new report on the NHS in England and Wales’ environmental sustainability was launched in London on the 21st April. The findings provide an informative overview of the organisation's environmental performance, and includes:

· An investigation into all resources consumed by the NHS in England

and Wales.

· A benchmark of environmental performance.

· Scenarios for hot water heating, transport and waste. The domestic waste scenario, for example, found that the ecological footprint

could be reduced by up to 49%.

· Placing the NHS’ delivery of healthcare services in the context of environmental sustainability in England and Wales

The Material Health study was commissioned by the Royal Society for Nature Conservation (RSNC), and is funded by NHS Estates, with a grant from Biffaward, a multi-million pound environment fund that utilises landfill tax credits donated by Biffa Waste Services. Data on the consumption of energy, materials and water, waste generated, and the use of transport in the NHS in England and Wales was used to map the flow of resources into, out of and within the NHS, and to calculate the ecological footprint of the staff, patients and visitors. This provided a baseline measure of the organisation's environmental impact.

The report has shown the following interesting findings:-

In 2001 the NHS in England and Wales,

· Consumed 2.4 million tonnes or resources (excluding water and oxygen)

o Almost 400,000 tonnes, or 15%, was discarded as waste, while

o Over 1 million tonnes remained within the NHS as stock.

· Consumed over 1 million tonnes of fuels to deliver the energy

o 3.2 million tonnes of emissions to air were generated, of which

o 99.6% was carbon dioxide.

· Consumed over 1.3 million tonnes of products, at an estimated value of £11.6 billion.

o Medical & surgical equipment, such as scanners and X-ray equipment, represented 31% of all materials used.

o In comparison, medical and surgical supplies, such as pharmaceuticals, weighed only 52,000 tonnes (4% of total

consumption) but accounted for 73% of total expenditure.

Other interesting facts:

· The NHS was supplied 49.8 million litres of water, of which 14% was lost through leakage.

· 12,650 GWh of energy was consumed, of which 62% was gas.

o Overall, this is approximately 1% of the total energy consumed in England and Wales.

· Over 53 thousand tonnes of food was consumed (by staff, patients and visitors).

o Milk & cream was the largest food category, making up 24% of total food consumed.

· Staff, patients and visitors travelled almost 25 billion passenger kilometres for NHS related purposes, of which

o 83% was by car or van.

An ecological footprint is an estimate of the land and sea area needed to provide all the energy, water, transport, food, materials, products and services that are consumed. The ecological footprint of the NHS in England and Wales was 4,964,825 global hectares in 2001.

The ecological footprint of NHS’ service provision can also be allocated in other ways, such as:

· Between the people it serves: In 2001, the NHS accounted for 2% of the ecological footprint per person in England and Wales.

· Between the 58 million patient episodes in 2001: As an indicator of eco-efficiency of service provision, the ecological footprint per

patient episode was 0.09 global hectares.

The study has produced a range of sustainability scenarios, which show how the organisation’s environmental impact can be reduced by initiatives such as waste reduction and minimisation, renewable energy, and increased use of public transport.

For further information on the report contact Nicola Jenkin at Best Foot Forward Tel: 01865 250818, e-mail: nicola@bestfootforward.com.

The report is available for download on

www.materialhealth.com

EDITOR'S NOTES:

1. In December 1997 Biffa Waste Services agreed to donate landfill tax credits to the Royal Society for Nature Conservation (RSNC) to administer under the fund name Biffaward. The fund is currently worth more than £14 million a year. The fund supports many worthwhile environmental projects involving local communities, biodiversity and research into sustainable waste management.

2. NHS Estates is an executive agency of the Department of Health. Their role is to provide advice, information and guidance on estates and facilities management issues to the ministers, Department of Health and the NHS, and to also support the delivery of services in the NHS

3. Best Foot Forward is a sustainability consultancy specialising in resource flow analysis and ecological footprinting. They recently completed a resource flow and ecological footprint analysis of Greater London www.citylimitslondon.com. For further information on Best Foot Forward, see www.bestfootforward.com

4. Stockholm Environment Institute (York University) is an independent, international research organisation committed to the implementation of practices supportive of global sustainable development. SEI conducts a comprehensive research, consulting and training programme which focuses on the links between the ecological, social and economic systems at global, regional and national and local levels. They recently completed an ecological footprint of York.

5. Royal Society for Nature Conservation (RSNC) supports local, regional and national environmental projects, carried out by charities and not-for-profit organisations. In addition to managing and administering several grant giving schemes, RSNC also coordinates the strategic activities of The Wildlife Trusts throughout the UK.

Press Release: April 2003

Material Health - A major study to assess the NHS' sustainability

A major study has been commissioned to quantify the use of natural resources by the NHS in England and Wales. The study will also investigate the consumption patterns of NHS staff, patients and visitors and assess the ecological sustainability of their activities within the organisation. 

The 'Material Health' study, has been commissioned by the Royal Society for Nature Conservation (RSNC), and is funded by NHS Estates, with a grant from Biffaward, a multi-million pound environment fund that utilises landfill tax credits donated by Biffa Waste Services.  The research will collect detailed data on the consumption of energy, materials and water, waste generated, and the use of transport in the NHS (England & Wales).  This information will be used to map the flow of resources into, out of and around the NHS and to calculate the 'ecological footprint' of the staff, patients and visitors - a baseline measure of the organisation's environmental impact.

The study will also develop a range of sustainability scenarios, which will show how the ecological footprint could be reduced by initiatives such as waste reduction and minimisation, renewable energy, and increased use of public transport. The likely impacts of continuing with existing patterns of consumption will also be assessed.

Commenting on the project Peter Wearmouth, NHS Estates Chief Executive said "This study will provide the first complete overview of the impact of NHS activities in England and Wales on the environment, and will be a valuable tool in the debate on the future direction of the NHS' economic, social and environmental policies"

The King's Fund, the Major Contractors' Group and NHS Purchasing and Supply Agency also support the project.  Best Foot Forward and the Stockholm Environment Institute (York University) who are carrying out the research, will be working with a wide range of NHS agencies, trusts and facilities to make the study as complete as possible.  Best Foot Forward, who are managing the project, will also calculate the ecological footprint.

Further information:

For further information or if you would like to contribute to the project, contact Nicola Jenkin at Best Foot Forward

Tel:  01865 250818      E-mail:  nicola@bestfootforward.com

Editor's notes:

1.  Best Foot Forward is a sustainability consultancy specialising in resource flow analysis and ecological footprinting.  They recently completed a resource flow and ecological footprint analysis of Greater London www.citylimitslondon.com.  For further information on Best Foot Forward, see www.bestfootforward.com

2.  In December 1997 Biffa Waste Services agreed to donate landfill tax credits to the Royal Society for Nature Conservation (RSNC) to administer under the fund name Biffaward.  The fund is currently worth more than £14 million a year.  The fund supports many worthwhile environmental projects involving local communities, biodiversity and research into sustainable waste management.

3.  NHS Estates is an executive agency of the Department of Health.  Their role is to provide advice, information and guidance on estates and facilities management issues to the ministers, Department of Health and the NHS, and to also support the delivery of services in the NHS.

 4.  Stockholm Environment Institute (York University) is an independent, international research organisation committed to the implementation of practices supportive of global sustainable development. SEI conducts a comprehensive research, consulting and training programme which focuses on the links between the ecological, social and economic systems at global, regional and national and local levels.  They recently completed an ecological footprint of York. 


 Maintaining a healthy planet

Health Business, Volume 3.6, Nov/Dec 2003, p65

Written by Nicola Jenkin, Projects Manager, Best Foot Forward  

The Material Health project is measuring the environmental impact of the NHS.  It aims to be viewed as a sustainability indicator and assist in any future decision making.  

The Material Health project began about a year ago, to try and analyse the environmental impact of the NHS in England and Wales.  Mass balance and ecological footprint methodologies are being used for the analysis.  Peter Wearmouth, NHS Estates Chief Executive said, "This study will provide the first complete overview of the impact of NHS activities in England and Wales on the environment, and will be a valuable tool in the debate on the future direction of the NHS' economic, social and environmental policies."   Material Health is also seen as a project that will provide information to support current NHS sustainability initiatives and policies, as well as a further development on projects, such as The King's Fund's 'Claiming the Health Dividend'.

The project was commissioned by the Royal Society for Nature Conservation (RSNC) and funded by Biffaward and NHS Estates.  Biffaward is a landfill tax credit funded scheme, which to date has funded almost 700 projects throughout the UK - Material Health forms part of Biffaward's Programme on Sustainable Resource Use.  The research is being carried out by Best Foot Forward Ltd (who are also managing the project) and the Stockholm Environment Institute (York University).  The following organisations also sit on the project's advisory group:  The King's Fund, The Major Contractors Group and NHS Purchasing and Supply Agency.     

Project lowdown

The first phase of the project was to draw up a project data specification and to identify key data providers.  Where possible, data for the year 2001 was collected on energy, materials and products (including food), waste (clinical and domestic), transport, water and built land.  Our intention was to, in the first instance, use official NHS data, such as that from Estates Return Information Collection (ERIC) for energy, waste and water.  Wherever data was not available from the NHS, such as consumption of medical equipment, external data sources, such as the Office for National Statistics (ONS) were used.  By scaling down (proxying) national data, it was possible to estimate materials consumption by the NHS.  Hospitals and GP surgeries were used as case studies to gather primary data, such as pharmaceutical use and food consumption, to validate high level data calculations.  The case studies cover a broad range of hospitals and GP surgeries - representing the North/South geographical divide, small versus large Trusts and various types of Trusts, for example whether it was acute, community or specialist. 

The second phase of the project was to conduct a mass balance analysis of the NHS in England and Wales.  This involved the quantification of mass inputs (energy, materials and products (including food) and water), outputs (emissions and waste) and any changes to stock for the NHS in England and Wales during 2001[1].  In brief, most data was available in one format or another.  However, data on materials and products consumed by the NHS proved more difficult to obtain.  The final report will describe, amongst other issues and processes, how the data collected in phase one was analysed for the mass balance.

Phase three of the project involves the ecological footprint analysis of the NHS in England and Wales.  An ecological footprint is the area required to provide the goods and services consumed by individuals, communities or organisations.  It can also be derived for products or for particular activities.  Using an ‘area equivalence’ (or ‘land’ for short), the ecological footprint expresses how much of nature’s renewable bioproductive capacity (or interest) we are currently appropriating.  If more of nature’s interest is consumed than is available (i.e. nature’s ‘capital’ is being reduced), then it is possible to assume that the rate of consumption is not sustainable (Chambers et al, 2000). 

The ecological footprint of the NHS in England and Wales, will focus on the environmental impacts to which the NHS staff and patients are responsible.  This is referred to as the responsibility principle.

Scenarios

Material Health will also include scenarios.  With advice from the advisory group, and areas of interest highlighted during the data collection phase, potential scenarios were identified.  In particular, scenario identification criteria were based on:  relevance to the NHS, realistic implementation and data availability (scenarios are reliant on good quantitative data).  The scenarios are calculated using examples of best practice and any current NHS environmental sustainability-related targets.

To date phases one and two of the project have been completed.  The ecological footprint analysis and scenarios development are currently being undertaken. 

 

The final phase

The final phase of the project is to produce a report, which will be launched in the first half of next year.  It is not the intention of the report to provide recommendations.  However, it is hoped that the findings will be used to provide information for evidence-based policy, initiate action and support current environmental sustainability initiatives in the NHS, such as NEAT, NHS ProCure21, Clean Hospitals and the Better Hospital Food programme.  Hopefully, the Material Health report will also be viewed as a sustainability indicator and assist in any future decision making.   

 

It is also hoped that the findings will support or be used in current UK Sustainable Development Commission programmes funded by the Department of Health, such as 'Healthy Futures', which will focus on food procurement and construction, and 'Seeing the Wider Picture:  Primary Care Trusts and Sustainable Development', which is in collaboration with the NHS Alliance.

If you are interested in the outcomes of this project, and would like to be informed about the launch of the report or related press release, please send your details to Nicola Jenkin at Best Foot Forward Ltd, (email) nicola@bestfootforward.com or (tel)  01865 250818. 

 

For more information:

The Future Centre, 115 Magdalen Road,

Oxford, OX4 1RQ

Tel:  01865 250818

E-mail:  nicola@bestfootforward.com

www.materialhealth.com.

References:

Chambers, N.;  Simmons, C. &  Wackernagel, M.  2000.  Sharing Nature's Interest:  Ecological Footprints as an Indicator of Sustainability.  Earthscan, London.


[1] Further information on mass balance analysis and Mass Balance UK, a programme into which data collected for Material Health will be included, can be found at http://www.massbalance.org/

 

For further information about Material Health, contact Nicola Jenkin, Best Foot Forward, Tel:  01865 250818 or e-mail:  nicola@bestfootforward.com